96 articles - From Thursday Oct 19 2023 to Thursday Oct 26 2023
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Aliment Pharmacol Ther |
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Liver biopsy for assessment of suspected drug-induced liver injury in metabolic dysfunction-associated steatohepatitis clinical trials: Expert consensus from the Liver Forum. Although there are no pathognomonic features, histologic evaluation of suspected DILI during MASH clinical trials may alter patient management, define the pattern and severity of injury, detect findings that favour a diagnosis of DILI versus MASH progression, identify prognostic features, characterise the clinicopathological phenotype of DILI, and/or define lesions that influence decisions about trial discontinuation and further development of the drug. |
| Gastroenterology |
AGA Clinical Practice Update on the Role of Artificial Intelligence in Colon Polyp Diagnosis and Management: Commentary. Methods This CPU was commissioned and approved by the AGA Institute Clinical Practice Updates Committee (CPUC) and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership and underwent internal peer review by the CPUC and external peer review through standard procedures of Gastroenterology. This Expert Commentary incorporates important as well as recently published studies in this field, and it reflects the experiences of the authors who are experienced endoscopists with expertise in the field of artificial intelligence and colorectal polyps. |
| Hepatology |
Validation of AGA clinical care pathway and AASLD practice guidance for nonalcoholic fatty liver disease in a prospective cohort of patients with type 2 diabetes. Validation of the AGA clinical pathway in a prospectively recruited cohort with T2DM revealed a low false negative rate and avoided specialty referral in a large percentage of patients. The AASLD pathway with FIB-4 + ELF resulted in a high rate of specialty referral, which improved with utilization of higher ELF cut-points and may serve as an alternative for primary care and endocrinology clinics without access to VCTE. |
| J Hepatol |
EASL-ERN position paper on liver involvement in patients with Fontan-type circulation. However, based on the increasing number of adult Fontan patients and recent research interest, the European Association for The Study of the Liver and the European Reference Network on Rare Liver Diseases thought a position paper timely. The aims of the current paper are: (1) to provide a clear definition and description of FALD, including clinical, analytical, radiological, haemodynamic, and histological features; (2) to facilitate guidance for staging the liver disease; and (3) to provide evidence- and experience-based recommendations for the management of different clinical scenarios. |
meta-analyses and systematic reviews
| Aliment Pharmacol Ther |
|---|
Systematic review: Glycomics as diagnostic markers for hepatocellular carcinoma. Alterations in serum N-glycomics, characterised by increased levels of fucosylation and branching, have potential as diagnostic biomarkers for HCC. Optimisation of study design, patient selection and analysing techniques are needed before clinical implementation will be possible. |
| Am J Gastroenterol |
Prevalence and characteristics of covert/minimal hepatic encephalopathy in patients with liver cirrhosis: A systematic review and meta-analysis. This study reports detailed data on the prevalence of C/MHE as well as clinical features associated with C/MHE, suggesting that C/MHE is one of the most common complications of liver cirrhosis. |
| Clin Gastroenterol Hepatol |
Prevalence of Barrett's Esophagus and Adenocarcinoma With and Without Gastroesophageal Reflux: A Systematic Review and Meta-Analysis. BE prevalence in those without GERD is substantial, particularly in large high-quality population-based studies. These data are important to factor in future BE/EAC early detection guidelines. |
| Gastrointest Endosc |
Safety and adverse events of endoscopic ultrasound-guided gallbladder drainage using lumen-apposing metal stents and percutaneous cholecystostomy tubes: A systematic review and meta-analysis. EUS-GBD-LAMS is a safer option than PTGBD and is associated with a shorter hospital stay in non-surgical candidates with AC. |
| Hepatology |
Association between hepatitis delta virus with liver morbidity and mortality: A systematic literature review and meta-analysis. Patients with HDV RNA+ status have a significantly greater risk of liver disease progression than patients who are HDV RNA-. These findings highlight the need for improved HDV screening and linkage to treatment to reduce the risk of liver-related morbidity and mortality. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
|---|
Recent trends and risk factors associated with Clostridioides difficile infections in hospitalized patients with inflammatory bowel disease. Rates of CDI among hospitalized patients with IBD had initially increased, but have declined since 2015. Increased comorbidity, large hospital size, public insurance, and urban teaching hospitals were associated with higher rates of CDI. CDI was associated with increased mortality in hospitalized patients with IBD. Continued vigilance, infection control, and treatment of CDI can help continue the trend of declining infection rates. |
Retrospective cohort study: Effect of age as a barrier to diagnosis of eosinophilic oesophagitis. Elderly patients with EoE have <50% the odds of oesophageal biopsies. There were no significant differences between elderly and non-elderly EoE patients, although endoscopic features helped discriminate the two groups. Our findings suggest that older age represents a barrier to EoE diagnosis. |
| Am J Gastroenterol |
EFFECT OF GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONISTS ON BOWEL PREPARATION FOR COLONOSCOPY. The use of GLP-1RAs was associated with a statistically significantly lower quality of bowel preparation, with additional clinical significance given a notable difference in the need for a repeat colonoscopy. It will be essential to understand the cumulative effect of medications that may delay gastric emptying on the quality of bowel preparation to better understand the appropriate measures and counseling that need to be taken before undergoing outpatient colonoscopies. |
| Clin Gastroenterol Hepatol |
Metabolic dysfunction-associated steatotic liver disease facilitates hepatitis B surface antigen seroclearance and seroconversion. In untreated HBeAg-negative CHB patients, concurrent MASLD is associated with higher rates of HBsAg seroclearance and seroconversion. Metabolic dysfunctions have additive effects on the functional cure of CHB. |
Province-Wide Ascertainment of Lynch Syndrome in Manitoba. A tumour screening program is more effective at detecting individuals with lower penetrant gene variants and families who do not meet traditional family history-based criteria. Cascade genetic testing is higher among clinic referrals compared to the screening program. These findings suggest a complementary role of these two ascertainment methods for Lynch syndrome. |
Real World Surgical and Endoscopic Recurrence Based on Risk Profiles and Prophylaxis Utilization in Postoperative Crohn's Disease. Clinical risk factors accurately illustrate patients at risk for surgical recurrence, but have limited utility in predicting endoscopic recurrence. Biologic prophylaxis may be of benefit irrespective of risk stratification and future studies should assess this. |
Significance of Crypt Atypia in Barrett's Esophagus: A Clinical, Molecular and Outcome Study. Patients with BE likely develop dysplasia via a progressive increase in the level of crypt atypia prior to the onset of dysplasia, and these changes may reflect some alteration of DNA content. |
Snare tip soft coagulation vs argon plasma coagulation vs no margin treatment after large non-pedunculated colorectal polyp resection: a randomized trial. In a randomized trial STSC and APC were each superior to no thermal margin treatment after EMR. STSC was faster to apply than APC. Because STSC also results in lower cost and plastic waste than APC (APC requires an additional device ), our study supports STSC as the preferred thermal margin treatment after colorectal EMR. (, Number NCT03654209). |
| Endosc Int Open |
Additional information obtained from mucosal biopsies is limited after pan-enteric capsule endoscopy in patients with suspected Crohn's disease. In patients with suspected CD and an evident result of CE, the additional information obtained from biopsies is limited, and CE as a single diagnostic procedure might be feasible in selected patients. Biopsies are warranted, however, in patients with an atypical endoscopic appearance or suspected malignancy. |
EUS-guided transcolonic drainage and necrosectomy in walled-off necrosis: a retrospective, single-center case series. We included nine patients and found a technical success rate of 100%, clinical success in 89%, and one adverse event (11%). Transrectal/transcolonic endoscopic necrosectomy was needed in seven patients (78%). |
| Endoscopy |
Direct diverticular peroral endoscopic myotomy for the treatment of thoracic esophageal diverticula: technique and outcomes. DD-POEM was a safe technique for the management of thoracic esophageal diverticula. Owing to its simplicity and excellent performance it should be further evaluated for the treatment of this disorder. |
| Gastroenterology |
Helicobacter pylori Treatment and Gastric Cancer Risk after Endoscopic Resection of Dysplasia: A Nationwide Cohort Study. In this nationwide cohort, H. pylori therapy after endoscopic resection of gastric dysplasia was associated with a reduced risk of gastric cancer and metachronous gastric neoplasm occurrence. |
| Gastrointest Endosc |
Anchoring fins of fully covered self-expanding metal stents affect pull-out force and stent migration. The pull-out force as biomechanical stent property predicts the migration resistance of FCSEMS in distal biliary stenosis and may thus be used to classify stents for this application. AF-FCSEMS showed a significantly lower rate of migration and adverse events compared to FE-FCSEMS. |
Endoscopic resection of giant esophageal subepithelial lesions: experience from a large tertiary center. ER serves as a promising therapeutic option for esophageal g-SELs. A younger age, large tumor size, irregular shape and extraluminal growth may indicate increased ER difficulty, while a STER procedure tends to be of lower difficulty. Our nomogram model performs well to predict ER difficulty for esophageal g-SELs. |
Hybrid Resection versus Conventional Resection for Laterally Spreading Lesions of the Papilla. The novel hybrid resection technique for LSL-P management is associated with a high rate of RRA that is recalcitrant to treatment, without mitigating the risk of intraprocedural or delayed bleeding. Therefore, conventional hot-snare resection should remain the mainstay management option for treating patients with an LSL-P. |
Novel powered 5.0 mm endoscopic debridement catheter for endoscopic transmural necrosectomy of pancreatic walled-off necrosis: A case series of consecutive patients from a tertiary referral center (with video). Endoscopic necrosectomy with the NecroMax 6.0 catheter was technically feasible in 96.7% with a low rate of adverse events. |
PREVALENCE AND CLINICAL SIGNIFICANCE OF THE MUSCLE-RETRACTING SIGN DURING ENDOSCOPIC SUBMUCOSAL DISSECTION OF LARGE MACRONODULAR COLORECTAL LESIONS (WITH VIDEO). MRS decreases oncological outcomes and increases the perforation rate. Consequently, procedures in the colon should be stopped if MRS is detected, and those in the rectum should be continued due to the morbidity of alternative therapy. |
Pancreatic Cyst Features Predict for Future Development of Pancreatic Cancer: Results of a Nested Case-Control Study. Age, cyst size, cyst growth rate, and high-risk or worrisome features are associated with higher risk of developing pancreatic cancer. Applying current and developing novel strategies are required to optimize early detection of pancreatic cancer after cyst diagnosis. |
Preoperative endoscopic biliary drainage by metal versus plastic stents for resectable perihilar cholangiocarcinoma. Stent failure was lower in patients with SEMS as PBD compared to plastic stents in patients with resectable pCCA. Removal during surgery was well feasible. Surgical outcomes were comparable. |
Validation and update of clinical score model to predict technical difficulty of colorectal endoscopic submucosal dissection: A multicenter prospective cohort study. The original model achieved an acceptable level of prediction in the prospective cohort. The updated model exhibited superior performance and can be used in place of the previous version. |
Western outcomes of circumferential endoscopic submucosal dissection for early esophageal squamous cell carcinoma. In Western referral centers, cESD for ESCC is curative in approximately half of the lesions. It can be considered a feasible treatment in selected patients. Our results suggest the need to improve patient selection and to develop more effective therapies to prevent esophageal strictures. |
| Gut |
Quantification of circulating HBV RNA expressed from intrahepatic cccDNA in untreated and NUC treated patients with chronic hepatitis B. Our results support the usefulness of quantification of circulating HBV RNA expressed from cccDNA as an indicator of intrahepatic active viral reservoir in both untreated and NUC-treated CHB patients. |
| Hepatology |
Development of Fibro-PeN, a clinical prediction model for moderate to severe fibrosis in children with nonalcoholic fatty liver disease. Existing fibrosis prediction models have limited clinical utility in children with NAFLD. Fibro-PeN offers improved performance characteristics for risk stratification by identifying moderate-to-severe fibrosis in children with NAFLD. |
FMO2 ameliorates nonalcoholic fatty liver disease by suppressing ER-to-Golgi transport of SREBP1. In hepatocytes, FMO2 is a novel molecule that protects against the progression of NAFL/NASH independent of enzyme activity. FMO2 impairs lipogenesis in HFD or CDAHFD-induced steatosis, inflammation and fibrosis by directly binding to SREBP1 and preventing its organelle translocation and subsequent activation. FMO2 thus is a promising molecule for targeting the activation of SREBP1 and for the treatment of NAFL/NASH. |
Impact of radiological response and pattern of progression in patients with hepatocellular carcinoma treated by atezolizumab- bevacizumab. RECIST 1.1 and mRECIST criteria predict OS with more responders identified by mRECIST and appearance of new extrahepatic lesion or vascular invasion was associated with a poor prognosis. A noticeable discrepancy was observed between patients classified as progressor at reviewing and the decision reached during MTB. |
Macrophage STING-YAP axis controls hepatic steatosis by promoting autophagic degradation of lipid droplets. Macrophage STING-YAP axis controls hepatic steatosis by reprogramming lipid metabolism in a TMEM205/MFN2/PDI-dependent pathway. These findings highlight the regulatory mechanism of macrophage STING-driven YAP activity on lipid control. |
Mendelian randomization in hepatology: A review of principles, opportunities, and challenges. In this concise review, we describe the concepts, assumptions, and interpretation of Mendelian Randomization as related to studies in hepatology. We focus on the strengths and weaknesses of the approach for a non-statistical audience, using an illustrative example to assess the causal relationship between body mass index and non-alcoholic fatty liver disease. |
New insights into the molecular basis of alcohol abstinence and relapse in alcohol-associated liver disease. In addition, support with psychological and behavioral treatments is essential to address the multiple dimensions of AUD. In the future, a personalized approach considering these novel targets can contribute to significantly decreasing the alcohol-related burden of disease. |
Wnt/ß-catenin and NF This study revealed a network of NF |
| J Hepatol |
A prospective, multicenter, three-cohort study evaluating contrast-induced acute kidney injury (CI-AKI) in patients with cirrhosis. AKI risk after CECT in cirrhosis is low, not significantly different from that of the general population and of the cirrhotic population unexposed to ICM. It mostly consists in mild and rapidly resolving episodes of renal dysfunction and it is not associated with tubular kidney injury. Patients with ongoing infections appear to be the only ones at higher risk of AKI. Impact and implications Nephrotoxicity due to intravenous iodinated contrast media (ICM) in patients with cirrhosis is still a debated issue, as the available evidence is limited and based on very heterogeneous studies, often conducted on small and retrospective cohorts. In this prospective three-cohort study we found that intravenous administration of ICM was associated with a low risk of AKI, similar to that of the general population and to that of patients with cirrhosis unexposed to ICM. Patients with ongoing infections were the only to have a significantly increased risk of CI-AKI. Therefore, the actual recommendations of performing contrast imaging studies cautiously in cirrhosis do not seem to be reasonable anymore, with the exception of infected patients, which have a significantly higher risk of CI-AKI. |
Higher TP53BP2 expression is associated with HBsAg loss in peginterferon-alpha-treated patients with chronic hepatitis B. Rs7519753 C allele is associated with an increased probability of serum HBsAg loss in patients with CHB post-Peg-IFNa treatment and elevated hepatic TP53BP2 expression. TP53BP2 enhances the response of the hepatocyte to IFN-a by suppressing SOCS2 expression. Impact and implications Chronic Hepatitis B (CHB) remains a global public health issue. Although current antiviral therapies are more effective in halting disease progression, only a few patients achieve functional cure for hepatitis B with HBsAg loss, highlighting the urgent need for a cure for CHB. This study revealed that the SNP rs7519753 C allele, which is associated with high expression of hepatic TP53BP2, significantly increases the likelihood of serum HBsAg loss in CHB patients undergoing Peg-IFNa therapy. This finding not only provides an exciting predictor for HBsAg loss but identifies a potential therapeutic target for Peg-IFNa treatment. We believe our results are of great interest to a wide range of stakeholders, including patients and patient organizations, the medical community, academia, the life science industry, and the general public. |
Immune responses and clinical outcomes after COVID-19 vaccination in patients with liver disease and in liver transplant recipients. After three COVID-19 vaccines, patients with liver disease generally develop robust antibody and T cell responses to vaccination and have mild COVID-19. However, LTR have sustained no/low antibody titres and appear most vulnerable to severe disease. Impact and implications Standardised assessments of the immune response to different COVID-19 vaccines in patients liver disease are lacking. We performed antibody and T cell assays at multiple timepoints following up to three vaccine doses in a large cohort of patients with a range of liver conditions. Overall, the three most widely available vaccine platforms were immunogenic and appeared to protect against severe breakthrough COVID-19. This will provide reassurance to patients with chronic liver disease who were deemed at high risk of severe COVID-19 during the pre-vaccination era, however, liver transplant recipients had the lowest antibody titres and remained vulnerable to severe breakthrough infection. We also characterise the immune response to multiple SARS-CoV-2 variants and describe the interaction between disease type, severity, and vaccine platform. These insights may prove useful in the event of future viral infections which also require rapid vaccine development and delivery to liver patients. |
Predicting survival in patients with 'non-high-risk' acute variceal bleeding receiving ß-blockers+ligation to prevent re-bleeding. The majority of 'non-high-risk' patients with AVB have an excellent outcome, if treated according to current recommendations. However, about one fifth of patients, i.e., those with CTP =8 and/or high creatinine levels or hyponatremia, have a considerable risk of death within 1 year of the index bleed. Future clinical trials should investigate whether elective TIPS placement reduces mortality in these patients. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Clin Gastroenterol Hepatol |
|---|
Common Instances of Low-value Care in Inflammatory Bowel Diseases. This review is meant to bring attention to value-based care in IBD and provide guidance to treating practitioners. Future studies on systematic evaluation of high- and low-value care in patients with IBD are warranted. |
Gluten-Related Disorders from Bench to Bedside. Distinguishing between these entities can be daunting. In this review we compare and contrast celiac disease, non-celiac gluten sensitivity, and wheat allergy to allow clinicians to determine which diagnosis fits their patient to facilitate high-quality management and longitudinal care. |
| Gastrointest Endosc |
| J Hepatol |
Digital pathology and artificial intelligence in non-alcoholic steatohepatitis: current status and future directions. This narrative review provides an overview of DP/AI tools in development for NASH, highlights key regulatory considerations, and discusses how these advances may impact the future of NASH clinical management and drug development. This should be a high priority in the NASH field, particularly to improve the development of safe and effective therapeutics. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
|---|
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gut |
| Hepatology |
| J Hepatol |
Letters to the editors and authors’ replies
| Clin Gastroenterol Hepatol |
|---|
| Gastroenterology |
| Gastrointest Endosc |
| Gut |